Analysis Of The Relative Factors For Reperfusion Arrythmia During Percutaneous Coronary Intervention In Patients With Acute Myocardial Infarction

Objective : To elucidate the relative factors for reperfusion arrythmia during percutaneous coronary intervention(PCI) in patients with acute myo- cardial infarction (AMI) .Methods : A total of 167 patients with AMI who underwent PCI were analyzed retrospectively.They were divided into reperfusion arrythmia group and no reperfusion arrythmia group.Multivariate logistic regression was used to identify independent relative factors among clinical and angiographic factors for occurrence of reperfusion arrythmia.The reper- fusion arrythmia group was divided into rapid arrhythmia group and slow arrhythmia group.Analysis the difference of related factors of the two group.Results : Reperfusion arrythmia occurred in 79 out of 167 patients. Inferior wall MI/Posterior wall MI /Right ventricular MI[67.1% (53/79) vs 18.2%(16/88),P<0.001], occlusion of RCA [54.4%(43/79)vs 17.0% (15/88), P<0.001], percentage of TIMI flow grade 0 on initial angiogram [79.7% (63 /79) vs 46.6% (41/88), P<0.001] , Attack-to-Balloon Time≤6hours [63. 3% (50/79) vs 46.6 % (41/88), P=0.031] were signifycantly higher and pre- infarction angina[38.0% (30/79) vs 61.4% (54/88), P=0.002], seriou con- gestive heart failure(Killip class≥Ⅱ)[8.9% (7/79) vs 20.5% (18/88), P= 0.036] was significantly lower in reperfusion arrythmia patients than no reperfusion arrythmia group patients. Logistic regression analyses showed that Inferior wall MI/Posterior wall MI /Right ventricular MI(OR 8.756, 95%CI 3.113-24.631) ,TIMI flow grade 0 on initial angiogram(OR 5.381, 95%CI 1.908-15.175)and Attack-to-Balloon Time≤6 hours(OR 3.264, 95% CI 1.099-9.694) were independent predictors of reperfusion arrythmia. Inferior wall MI/Posterior wall MI /Right ventricular MI [82%(41/50)vs 41.4% (12/29), P<0.001], occlusion of RCA [70.0%(35/50)vs 31.1% (9 /29),P<0.001] were significantly higher in slow arrythmia patients and Anterior wall MI [58.6% (17/29) vs 18.0%(9/50) , P< 0.001],occlusion of LAD[58.6% (17/29) vs 18.0%(9/50),P<0.001]were significantly higher in rapid arrythmia patients.Conclusion : Inferior wall MI/Posterior wall MI /Right ventricular MI, TIMI flow grade 0 on initial angiogram and Attack-to-Balloon Time≤6 hours were independent risk factors for reperfusion arrythmia. Inferior wall MI/Posterior wall MI /Right ventricular MI, occlusion of RCA were significantly higher in slow arrythmia patients and Anterior wall MI , occlusion of LAD were significantly higher in rapid arrythmia patients.